Decision-Making Case Study

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Decision-Making Case Study
HCS/514
Decision-Making Case Study
The looming changes in health care are a frequent topic in many meetings with health care providers. Budget cuts are not just a speculation but are a reality. Decision-making to provide quality patient care with less money is a challenge at best. The Informed Decisions Toolbox can assist administrators and managers with evidence-based decisions that will allow patients to receive the quality care they deserve while reducing expenses. The Informed Decisions Toolbox

The Informed Decisions Toolbox (IDT) is the result of a research study to aid managers with making evidence-based decisions that improve organizational performance. The IDT has an approach of six steps to decision-making (Rundell, et al, 2007): (1) framing the management question, (2) finding sources of information, (3) assessing the accuracy of the information, (4) assessing the applicability of the information, (5) assessing the actionability of the evidence, and (6) determining if the information is adequate (p. 325). As a facilitator for the use of evidence-based research in decision-making, the IDT assists decision-makers with estimating how operational and strategic decisions will have an effect on the organization. Evidence-based decision-making is not new to the health care industry. Clinicians have incorporated evidence-based research for years when making patient treatment determination. The use of evidence-based research for decision-making in other realms of healthcare is only logical.

Case Study Example
A manager of a Denton County, Texas, clinic that provides care to Medicaid clients has a department budget cut of 15%. A decision for eliminating or introducing clinical services to best address the healthcare needs of the Medicaid population is necessary. The decision should consider statewide health policy and a defined budget constraint. Framing the management question (Step 1)

Framing the management question involves asking oneself a series of questions that will elicit a well-defined research question that focuses on an objective outcome. In the above example, one may ask the following (Rundell, et al, 2007): * What is the proposed change?

* A department budget cut of 15% in a clinic that serves Medicaid patients. * What are the main outcomes of interest?
* Elimination or addition of services to provide the best patient care within the budget constraints. * What is the setting for the change?
* A Denton County, Texas, clinic serving Medicaid patients. * What is the timeframe for the managerial changes and for the outcomes? * The beginning of the 2013 fiscal year.
* What are the relevant populations?
* The clinic serves Medicaid patients.
* The state of Texas has three categories for Medicaid recipients (Texas Health and Human Services Commission, 2012b): * Families and children – based on income level, depending on age or pregnancy * Cash assistance recipients – based on receipt of Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI) * Aged and disabled – based on income level, age, and physical or mental disability (p. 4-1). * 2011 (estimated) Denton County Medicaid enrollment was 40,042, 5.83% of the county population (Texas Health and Human Services Commission, 2012a). The question formulated from the information gathered is “How will a 15% budget reduction affect services provided for Texas Medicaid recipients in Denton County during fiscal year 2013?” Finding Sources of Information (Step 2)

Information to assist with decision-making can come from a variety of sources that primarily involves use of the Internet. Research skills are useful when attempting to formulate an evidence-based answer to a question. Searches for information in relation to the case study example ranged from a Texas Health and Human Services 2013-2017 strategic...
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